Thursday, December 5, 2013

WASHINGTON -- Climatic changes -- and the results of
those changes -- could occur within decades or even sooner, and they are
becoming a greater concern for scientists, according to a new paper from the
National Academy of Sciences.

"The most challenging changes are the abrupt
ones," said James White, a professor of geological sciences at the
University of Colorado in Boulder and chair of the report committee. White and
several coauthors of the paper spoke at a press conference Tuesday morning.

The
paper focuses on those impacts
due to climate change that can happen most quickly. Among these are the
rapid decline in Arctic sea ice that scientists have seen in the last decade
and increased extinction pressure on plants and animals caused by the rapidly
warming climate.

Many such changes, according to Tony Barnosky, a
professor in the Department of Integrative Biology at the University of
California, Berkeley, are "things that people in this room will be around
to see." He emphasized that scientists are "really worried about
what's going to happen in the next several years or decades."

"The planet is going to be warmer than most species
living on Earth today have seen it, including humans," said Barnosky.
"The pace of change is orders of magnitude higher than what species have
experienced in the last tens of millions of years."

Other, more gradually occurring changes can still have
abrupt impacts on the ecosystem and human systems, such as the loss of
fisheries or shifts in where certain crops can be cultivated. Rapid loss of
ice, for example, would mean that sea levels rise at a much faster rate than
the current trend, which would have a significant effect on coastal regions. A
3-foot rise in the seas is easier to prepare for if it happens on a 100-year
horizon than if it happens within 30 years.

"If you think about gradual change, you can see where the road is and
where you're going," said Barnosky. "With abrupt changes and effects,
the road suddenly drops out from under you."

The paper did offer two bits of good news. One,
scientists don't believe that climate change is likely to shut down the
Atlantic jetstream, a possibility that had been discussed in some scientific
research. They also don't believe that large, rapid emissions of methane from ice
and Arctic soil will pose a serious threat in the short term, as had been
considered previously.

"Giant methane belches are not a big worry,"
said Richard Alley, a professor of geosciences at Pennsylvania State University
and committee member. "These really are systems that will affect us in the
future, but they don't look like they're going to jump really fast."

The paper recommends increased investment in an
early-warning system for monitoring abrupt impacts, such as surveillance
programs to facilitate closer tracking of melting ice and methane releases, for
example. Right now, investment in those systems is lacking in the U.S., and
monitoring programs have been cut in recent years.

"The time has come for us to quit talking and
actually take some action," said White. He noted that in the modern age,
there are cameras everywhere, yet "remarkably very few of those watching
devices are pointed at the environment."

"We ought to be watching that with the same zeal we
watch banks and other precious things."

Tuesday, November 26, 2013

Welcome to
Wonkbook, Ezra Klein and Evan Soltas's morning policy news primer. To subscribe
by e-mail, click here. Send comments, criticism, or ideas to
Wonkbook at Gmail dot com. To read more by Ezra and his team, go to Wonkblog.

A spin through
HealthCare.Gov this morning went smoothly. The site loaded quickly. The process
progressed easily. There were no error messages or endless hangs. I didn't
complete the final step of purchasing insurance but, until then, the site worked
-- or at least appeared to work -- exactly as intended.

My experience
isn't rare. There are increasing reports that HealthCare.Gov is working better
-- perhaps much better -- for consumers than it was a few short weeks
ago. "Consumer advocates say it is becoming easier for people to sign up for
coverage," report Sandhya Somashekhar and Amy Goldstein in
the Washington Post. "The truth is, the system is getting stronger as it
recovers from its disastrous launch," writes Sam Baker in the National Journal.
Applying "was no problem at all, with no delays," says Paul
Krugman.

Reports from
inside the health care bureaucracy are also turning towards optimism. People who
knew the Web site was going to be a mess on Oct. 1st are, for the first time,
beginning to think HealthCare.Gov might work. Data backs them up: By
mid-November, the pace of enrollment in the federal exchanges had
doubled from what it was in October.

The Obama
administration is certainly acting like they believe the site has turned the
corner. Somashekhar and Goldstein report that they're "moving on to the outreach
phase, which had taken a back seat as they grappled with the faulty Web site.
Next week, the White House will host an insurance-oriented 'youth summit' aimed
at people ages 18 to 35, an age group whose participation in the health-care law
will be critical to its success."

The White House
had held off on this kind of outreach because they believed it would simply
drive people to a useless Web site. If they're restarting the outreach, it's
because they believe, rightly or wrongly, that HealthCare.Gov will be able to
convert the interest into enrollments.

The worry, at
this point, is that the site is working in ways that are visible but broken in
ways that are harder to see. The Obama administration won't answer direct
questions on the percentage of "834s" -- the forms insurers need to sign people
up for the correct policies at the correct prices -- that are coming through
with errors. Robert Laszewski, a health-industry consultant with deep contacts
among the insurers, told the National Journal the problem is getting
better, but that his clients are still seeing a five percent error rate. That's
still too high.

The systems that
determine whether applicants are eligible for insurance are also improving. But
inside the administration there's a recognition that it was error-ridden in the
first six weeks of Obamacare -- and so the question is how to handle the many
people who unknowingly received an eligibility determination that can't be
trusted.

Still, it's
clear that HealthCare.Gov is improving -- and, at this point, it's improving
reasonably quickly. It won't work perfectly by the end of November but it might
well work tolerably early in December. A political system that's become
overwhelmingly oriented towards pessimism on Obamacare will have to adjust as
the system's technological infrastructure improves.

The next
challenge for the law, as the White House knows, will be the outreach challenge
of signing up enough young-and-healthy people to balance out its risk pools.
That's a challenge the White House spent quite a lot of time thinking about before this IT
nightmare. The question is whether they still have enough time, and enough
clout, to get it right.

Monday, November 25, 2013

Here are some reflections on two significant events
in Washington last week concerning Senate productivity and Obamacare.

The Senate voted to return some degree of democracy
to that chamber.Senate
Majority Leader Harry Reid allowed a simple majority of the Senate to
approve allowing Presidential nominations (other than for the Supreme Court) to
be approved by a simple majority of Senators.The response to this feared “nuclear option” was, well, just more of the
same passive filibustering by the minority opposition refusing
to allow the Defense authorization bill to advance.Requiring a “talking filibuster” to hold up
any legislation in the Senate should be the next rule change.

Last week also saw a major step forward for
Obamacare.House
Speaker John Boehner enrolled in a health insurance plan through an online
healthcare marketplace.The world didn’t
end.No one lost their job.And the government did not get between
Speaker Boehner and his doctor.Take
notice Obamacare-haters.Your leader
willingly and successfully enrolled in Obamacare.

Below are some pics from my meeting last week with
Deputy Secretary of the U.S. Department of Energy Daniel Poneman in Charleston. The bottom pic includes Sandy Bridges, owner of Palmetto Hammock (49 S Market St, Charleston) and big supporter of our sea level rise education project (SCBARS.org) for small businesses.

Thursday, November 21, 2013

This just might be
my favorite chart about health care costs as of late. And it's one that
contains billions of dollars' worth of good news!

The chart, from the Council of
Economic Advisers, shows the Congressional Budget Office constantly
revising downward how much it thinks the federal government will need to spend
on health care costs over the next decade. That's because health care costs
have been growing a lot more slowly over the past few years than they typically
do. You can see that below, with a breakdown of health care cost growth by
source of coverage.

In private insurance, the average spending growth rate per
person has slowed a lot over the last few years. In Medicare, there was no
spending growth between 2010 and 2013 and, in Medicaid, per person costs
actually decreased some.

All told, health care costs have been growing more slowly over
the last three years than any other time period since 1965. More recently,
yearly health cost growth slowed from an average rate of 3.9 percent between
2000 and 2007 to 1.3 percent between 2011 and 2013.

The big health policy parlor game for the past few years has
been to ask: How much of this change is cyclical, owing to the recession, or
structural, partially due to the health law's payment reforms?

The White House has long argued that the changes are structural,
and it made that case again Wednesday in a briefing with reporters.

"The slowdown is indisputable," Council of Economics
Advisers chairman Jason Furman said. "A very important part of that is
structure, and a very important part of the structural story is the Affordable
Care Act."

Most health care economists now agree, at least to some extent,
with this more structural view. Even those who argue that the current
slowdown is unlikely to last, such as Harvard's Amitabh Chandra and
Dartmouth's Jonathan Skinner, still expect slower health care cost
growth in the next decade compared with the previous one.

And in some cases, that translates into better health care, too.
This chart from the council's report shows a significant drop in preventable
readmissions to hospitals (when treatment goes wrong the first time and
the patient must return to the hospital). That happened right around the time
Medicare began penalizing such return trips to the hospitals.

Cost savings aside, that's great news for patients, suggesting
that the quality of care hospitals are delivering is improving at the same time
that spending on that care is slowing down.

Wednesday, November 20, 2013

If there is anything you would like to say to the
U.S. Department of Energy, tell me today and I’ll deliver it tomorrow.

U.S. Department of Energy Deputy Secretary Daniel
Poneman will be in Charleston tomorrow.He will be at the dedication of Clemson University’s Energy Innovation Center, an 82,000 sq.ft. wind turbine drivetrain
testing facility.

Following the
dedication I will be meeting him at a business roundtable of local business
owners to discuss climate and energy issues.Mr. Poneman, Sandy Bridges (owner of Palmetto Hammock) and I will hold a
brief press opportunity following the roundtable.

Monday, November 18, 2013

With all the negative news surrounding the Health
Insurance Marketplaces, it sure is nice to hear success stories.

WBTV
in Charlotte ran this story last Friday.This couple is going to save 3 to 4 thousand dollars a year and get
better benefits through their successful use of Healthcare.gov.And the money they’re saving has nothing to
do with a government subsidy because they don’t qualify.

Then this weekend the Governors of Washington,
Kentucky and Connecticut, all states that are running their own health
insurance marketplaces, authored an opinion editorial in The
Washington Post that included this statement:

“The Affordable Care Act has been successful in our
states because our political and community leaders grasped the importance of
expanding health-care coverage and have avoided the temptation to use
health-care reform as a political football.”

As more of these positive stories come to light, the
supporters of Obamacare will hopefully stop being so defensive.This is going to work.Just be patient.